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Archivos de Medicina Interna

Print version ISSN 0250-3816On-line version ISSN 1688-423X


DA SILVA, Lourdes; SANGUINETTI, Alberto  and  LOPEZ, Virginia. Endoscopic markers of villous atrophy in patients with microcytic and/or iron deficiency anemia. Arch. Med Int [online]. 2010, vol.32, n.4, pp.59-63. ISSN 0250-3816.

Introduction: Upper gastrointestinal video-endoscopy (UGIVE) performed to patients with iron deficiency anemia (IDA) must include duodenal biopsies to rule out a potential Celiac Disease (CD), since this anemia is one of its forms of onset. Objective: To determine the value of the gross pathology elements of villous atrophy (VA) observed in the UGIVE in patients with IDA. Method: This was a longitudinal, retrospective study that includes an analysis of the reports of the duodenal endoscopies and biopsies and a review of the medical records. The patients enrolled were those undergoing UGIVE with duodenal biopsy, who presented with the clinical data of microcytic and/or iron deficiency anemia. Results: Seventy-two patients were enrolled. Duodenal atrophy endoscopic markers were evidenced in 10. Pathology confirmed VA in 8 cases (11.1%). Discussion: This work showed a positive predictive value (PPV) of 80% for the endoscopic signs present and a negative predictive value (NPV) of 100%. Although the series is small, this would support the indication of biopsy only in those patients that show gross VA signs in the endoscopy, despite the current recommendation in literature to take biopsies even in the absence of endoscopic signs. Conclusions: The high VPN would support the biopsy indication only in those patients that show VA signs in the endoscopy. The study should be continued to include a larger number of patients before a recommendation can be made.

Keywords : Iron deficiency anemia; Celiac disease; Endoscopic signs; Duodenal biopsy; Villous atrophy.

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